Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

Plastic surgery includes various procedures in order to repair body parts which are damaged and injured or for cosmetic reasons by transferring tissues. The most common procedures performed on patients are lipoplasty, breast augmentation, facelift, eyelid surgery and botox. There have been a lot of assumptions and myths around plastic surgery, but it is no different than any other medical procedures. Here are top plastic surgery myths that you need to be aware of.


	Women are the only customers: although women have been traditionally known to be the prime customers of plastic surgery, nowadays a lot of men are also opting for various procedures. Non penetrating mild procedures like botox, laser, and dermal fillers are highly popular among men. These are low cost and effective procedures that can make a mile of difference in your look.
	It's all about looking good: there are certainly many procedures focused on restructuring the body parts to enhance beauty but plastic surgery includes a lot of other procedures such as correcting sports injuries, burns, disfigurement due to an accident etc. Cosmetic surgeries are usually opted in those cases where normal exercises, diets and weight loss programs cannot alter the structure of a particular area.
	You will look young forever after opting for a plastic surgery: you can get procedures done to turn back time, but it is difficult to stay that way forever. Plastic surgery usually lasts for decades barring the non-invasive procedures such as botox and laser which are semi- permanent. A healthy lifestyle and occasional clinical touch ups can take away years from your look but it is humanly impossible to remain in the same way forever.
	Gives you smooth skin with no scars: there are procedures to reduce the appearance of scars but a surgery will sustain some kind of scar no matter how minuscule. Post surgery treatments are available to diminish scars but a slight remnant is to be endured.


If you are in need of plastic surgery it is advisable to gather necessary information before going through any procedure rather than believe assumptions.


Busting Plastic Surgery Myths

All You Need to Know about Breast Augmentation Surgery

Breast Augmentation is the most popular plastic surgery procedure performed worldwide.

Breast augmentation can enhance your appearance and your self-confidence, enlarging your breasts and making them more proportional with the rest of your body. Breast augmentation can also be used to correct differences in the size of your breasts or sagging breasts, which can occur after pregnancy and breastfeeding.

Preoperative Planning

There are many choices and options in breast augmentation, which require careful planning to individualize what are the best options for you. All of these choices have advantages and disadvantages, which you should understand before you make a decision with your surgeon.

Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.

Most patients choose silicone implants rather than saline implants because they have a more natural look and feel. Modern silicone implants are substantially different from the old type of silicone implants used in the 1970s and 80s. Another advantage of the cohesive gel silicone implants is that they are made in a variety of round and tear-drop shapes, which means it is easier to choose an implant to achieve the breast shape that you desire.

Safety Profile

Misinformation emerged about silicone in the late 80's and early 90's. The effects of silicone implants have since been studied extensively these claims were made, looking at 100,000s of women with breast implants. In June 1999, The Institute of Medicine at the National Academy of Sciences in the U.S.A. released a report, which confirmed that there is no increased risk of the development of cancer, immunologic or neurological problems associated with the use of silicone breast implants, which had been claimed in the late 80's. Patients with implants can breastfeed normally as there is no effect on breast milk.

Surgery

Breast augmentation surgery requires a general anaesthetic, with the operation taking 1-2 hours, and is usually performed as a day-stay or overnight-stay procedure.

Implants are placed either behind the breast tissue or under the pectoralis muscle on the chest wall. Breast implants placed underneath the muscle have a more natural shape, a lower chance of capsular contracture (hardening) of the implant, and it is easier for mammography. There is also a choice of incision - in the crease under the breast, under the areola or in the armpit, all of which have advantages and disadvantages, which you should discuss with your surgeon.

Recovery

Following the surgery, it is important to have restricted light activities, with no lifting or heavy duties for 7-10 days. Most patients may drive again and return to work within 7 days after the surgery. Heavy activities and sport should not be undertaken for 3-4 weeks following the surgery.



All You Need to Know about Breast Augmentation Surgery

Eczema is something which can really blight the quality of the life of a person. Sometimes, even the most mundane of things can cause our skin to have a reaction, resulting in allergic eczema. However, while it is annoying and painful, there are ways to go about treating it.

It is quite important, though, to understand what exactly eczema is. Simply put, it is a condition which occurs when the skin of the person suffering from it is inflamed.

Among the various groups of people who suffer from eczema, a lot of them are actually babies. However, they thankfully are able to grow out of the issue by the time they become adults. While it is true that eczema can strike any part of a person s body, among the places it strikes most often are the face, the neck and behind the sweat spots of the body i.e. the area behind the knees and around the ankles.

What causes allergic eczema?
Eczema is a lot of the time, a condition which is genetic. That being said, there are certain things which can go a long way into making it worse, which include stress and dry climates as well as external materials which irritate the skin touching it, like soaps which are just too strong.

What are the Treatment Options?
When it comes to things, which have the potential to make the situation a lot better, there is a group of medicines which are part of the antihistamine group which can work wonders. An interesting thing when it comes to the treatment of allergic eczema is the fact that a lot of the treatment for the issue involves a management of the inflammation that occurs along with an attempt to take better control and manage the immune system of the person who has eczema.

Depending on the severity of eczema a person has, a possible course of treatment involves making use of corticosteroids, which are strictly a prescription based way to go about treating eczema. Keeping this in mind, it is of the highest importance to make sure that whenever the steroids are being taken by mouth, there is a full adherence to what the doctor has recommended or directed.

As a last ditch resort, if the condition is really bad, there is a possibility of going for Ultra Violet Therapy in order to make it better. However, if one is looking for ways to reduce the intensity of their eczema sans higher doses of medication, stress management in something that can work well. In addition to this, a humidifier can do a lot to improve the situation.

Allergic Eczema - Ways You Can Contact It!

Dermatitis is a disorder where inflammation on the skin is caused. It is also known as eczema. Itchy, erythematous, vascular or crusting patches appear on the skin. Dermatitis denotes an acute condition, and eczema refers to a more chronic condition of the disease. Any form of dermatitis can be cured effectively using homeopathic medicines. Homeopathy helps in decreasing the severe itching associated with the disease and also the frequency of relapse.

Here are some primary homeopathic medicines, which are used in the treatment of Dermatitis:

Sulphur: This is said to be the best homeopathic medicine for treating Atopic Dermatitis. Very effective results are obtained when sulphur is used to cure dermatitis. It is used mainly when the skin gets excessively dry and develops scales, accompanied by itching. The itching reaches its peak during the night and is followed by a heated sensation in the affected area. In cases where sulphur is used, the skin looks dirty and unhealthy. The patient also has an increased craving for sweets and tends to avoid bathing.
Graphites: This medicine is the best natural remedy for Dermatitis which occurs in the folds of the skin. It may occur in the folds of the elbow, knee, behind the ear and neck. There may be rawness with the itching and eruptions occur in the skin folds. Glue-like discharge from the affected area is also indicated. Graphite also treats eczema on the face, nose, chin and the eyelids.
Rhus Tox: This is an effective homeopathic medicine used in the treatment of dermatitis due to asthmatic disorders. Rhus Tox is used when the skin turns red in color, and the itching is severe. Fluid-filled eruptions appear on the skin. Scaling of the skin is also common among asthmatic patients who develop dermatitis. Rhus Tox is usually used for dermatitis, which happens during the monsoon.
Mezereum: This is a very useful homeopathic medicine used for treatment of dermatitis where weeping eruptions appear on the scalp. The medicine is also used to cure oozing eruptions, which occur on the scalp. Mezereum is used when a thick scab is formed on the scalp which discharges thick pus. Ulcers and vesicles are likely to appear on the scalp.
Natrum Mur: It is used in cases of dermatitis where dry eruptions occur along the hairline, or in the margin of the scalp. Crusting takes place along the hairline as well. The patient develops an extra craving for salty food.
Homeopathy is a very effective form of medicine used for the treatment of dermatitis and there are homeopathic remedies for all types of dermatitis conditions. Not just the symptoms but the entire disease is cured from its roots using homeopathy.

Best 5 Homeopathic Medicine for Dermatitis Treatment - Safe Remedies

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